Werneburg, Brooke L.

Healthcare organizations face persistent tension between efficiency and human connection. Digital systems often fragment attention and unintentionally distance staff from patients. At Mayo Clinic, we developed a conversational artificial intelligence (AI) agent embedded in Microsoft Teams to address this challenge. Connecting and Communicating (CoCo) provides staff with communication guidance, drawing on institutional resources aligned with the Mayo Model of Communication (MMOC). Built in Microsoft Copilot Studio and shaped by clinicians and operational stakeholders, CoCo was designed to be values-aligned and usable within existing workflows. CoCo is an active, user-initiated tool used primarily before or after challenging interactions to support preparation, reflection, and communication planning. Staff valued CoCo as a “just-in-time coach” that reinforced empathy while reducing stress. From August 2025 through February 2026, CoCo supported 1,903 conversation sessions, with early descriptive analytics suggesting favorable satisfaction and response-quality signals. We share insights from development and deployment, along with practical recommendations, to support other organizations considering bespoke, values-aligned AI tools to enhance patient and staff experience. We distill practice-based implementation lessons around governance, human factors, and change management, and offer practical recommendations to inform similar efforts elsewhere.

Patient complaints are valuable sources of information for quality improvement and provide an avenue for patient self-advocacy. This paper outlines the development and implementation of a novel training program, termed CODE (Compassion, Operational Support, De-escalation, Empowerment), for patient experience complaint management staff. The program consists of 2 core tracks: procedural training on operational systems and resources, and interpersonal communication training. A dual-track framework ensures practical knowledge to access resources to assist complainants is paired with communication for empathy and human connection. The CODE program's dual-track structure is a key strength, bridging the gap between operational efficiency and compassionate communication. By emphasizing both procedural knowledge and interpersonal skills, it equips healthcare professionals to manage patient complaints successfully. The CODE program represents a novel approach for healthcare institutions seeking to optimize patient experience and complaint-handling performance.

Objective: Health coaching has the potential to improve self-management abilities (SM) in patients with Chronic Obstructive Pulmonary Disease (COPD). Patient engagement with health care providers has a beneficial effect on patient outcomes. We examined the association of patient engagement with the health coach on SM abilities in patients with COPD. Methods: We analyzed the association between the degree of engagement measured by the Working Alliance Inventory (WAI-SR) and the SM measured by the Self-Management-Ability-Scale-30 (SMAS-30) at the end of a COPD health coaching intervention. Results: The cohort included 146 moderate to severe COPD patients. The WAI-SR total score was 85% of the maximum possible scores indicating a high degree of engagement between the health coach and the patients. The WAI-SR Task and Bond domains were positively associated with SM abilities after adjusting for lung function (FEV1 %) and depression symptoms (PHQ-2). Conclusion: The degree of engagement between a health coach and patients is associated with the perception of SM abilities in patients with COPD. Our results may inform self-management intervention and clinical practice.

Background: In response to encounters involving misconduct, discrimination, and harassment toward healthcare workers, the Experience Training, Education, and Coaching (XTEC) team was tasked with empowering staff members to respond to biased requests and misconduct appropriately and consistently. The aim of this article is to discuss communication strategies for how to respond to patient bias and misconduct. Methods: XTEC developed a training program with two focused communication strategies: (1) SAFER, a stepped approach to respond to patient and visitor misconduct and (2) ASAP, an approach for responding to patient bias which we describe as requests related to race, religion, ethnicity, gender, and other personal attributes of staff. Intervention: SAFER ASAP workshops were delivered to 2154 health care professionals through 109 face-to-face training over a 15-month period between January 2019 and March 2020. All trainings were discussion- and scenario-based, ranging in duration from 60 to 90 min. Participants were given pre- and post-training test case scenarios, in which respondents wrote responses to a challenging behavior to assess skill attainment post-training. Results:Seventy-one percent demonstrated higher levels of response ability post-training, and 92% of respondents indicated they would likely recommend this training to others. Conclusions: SAFER ASAP is an effective communication training program for responding to patient and visitor bias and misconduct.

As of May 13, 2020, the number of confirmed SARS-CoV-2 (novel corona virus, COVID-19) infections has risen to 4 300 000 worldwide, with over 1 300 000 confirmed cases in the United States. Various prediction models of spread indicate more hospitalization, increased ventilator use, and the shifting of medical resources to most efficiently serve the patient’s needs. Additionally, mitigation strategies such as monitoring for symptoms, social distancing, safer at home, and the wearing of masks caused our institution to implement significant operational changes to our usual practice. This included screening patients and staff for symptoms, rescheduling routine medical visits, postponing procedures, converting face-to-face visits to telephone or video visits, and changing visitor visit policies. In this article, we describe the various ways we deployed empathic communication messaging and resources across the institution during the COVID-19 pandemic.

Purpose: This project examined potential changes in health behaviors following wellness coaching. Design: In a single cohort study design, wellness coaching participants were recruited in 2011, data were collected through July 2012, and were analyzed through December 2013. Items in the study questionnaire used requested information about 11 health behaviors, self-efficacy for eating, and goalsetting skills. Setting: Worksite wellness center. Participants: One-hundred employee wellness center members with an average age of 42 years; 90% were female and most were overweight or obese. Intervention: Twelve weeks of in-person, one-on-one wellness coaching. Method: Participants completed study questionnaires when they started wellness coaching (baseline), after 12 weeks of wellness coaching, and at a 3-month follow-up. Results: From baseline to week 12, these 100 wellness coaching participants improved their self-reported health behaviors (11 domains, 0- to 10-point scale) from an average of 6.4 to 7.7 ( p < .001), eating selfefficacy from an average of 112 to 142 (on a 0- to 180-point scale; p < .001), and goal-setting skills from an average of 49 to 55 (on a 16- to 80-point scale; p < .001). Conclusion: These results suggest that participants improved their current health behaviors and learned skills for continued healthy living. Future studies that use randomized controlled trials are needed to establish causality for wellness coaching.

AbstractHigh stress is a prevalent problem in the worksite. To reduce stress, improve productivity, reduce absenteeism, and lower healthcare costs, many companies offer exercise classes or stress management programmes. Although physical activity is an important component of stress management, few worksites have integrated physical activity into their comprehensive stress reduction programmes. The purpose of this single‐arm pilot project was to examine the potential effectiveness of an integrated exercise (studio cycling) and cognitive–behavioural stress management programme. Eighty‐four adults, 75% female, mostly aged 40+ years, participated in an integrated 12‐week cycling studio and cognitive–behavioural stress management programme. Participants experienced a significant and clinically meaningful reduction on the Perceived Stress Scale (p < 0.01), rating of current stress level and confidence to manage stress at the programme's end and at a 1‐month follow‐up. Participants also reported having significantly improved overall health, improved nutritional habits, higher physical activity level, greater confidence in their ability to follow a healthy diet, higher spiritual well‐being, improved sleep, receiving more support for maintaining healthy living and improved quality of life at the completion of the 12‐week programme and 1‐month follow‐up. These findings provide further support for an integrated exercise and stress management programme. Copyright © 2013 John Wiley & Sons, Ltd.

AbstractIt has been well established that a high level of stress is associated with medical problems, mental health difficulties and absenteeism at the workplace. The aim of this single‐arm study design was to examine the potential effectiveness of a 12‐session multidisciplinary stress reduction programme on reducing perceived stress and improving health behaviours and quality of life. One hundred and four women participated in a programme that incorporated group support, skill building and cognitive behavioural and relaxation techniques. A series of Bonferroni corrected t‐tests found that the participants reported having significantly (p < 0.001) lower levels of perceived stress, improved health behaviours (sleep, nutrition, physical activity) improved overall health and improved quality of life at the end of the 12 week programme and at 1‐month follow‐up. Although the effect sizes for improvement were all large, there was no control group, so regression to the mean or selection bias may have impacted the results. Therefore, these results provide initial support for the implementation of gender‐based worksite stress reduction programmes and provide guidance in designing an effective worksite stress reduction programme. Further research using randomized controlled trials is warranted. Copyright © 2011 John Wiley & Sons, Ltd.